Male Infertility Causes

Causes of Male Infertility

Male fertility is a composite process. In order to impregnate your partner, the following must happen.

  • Healthy sperm

Beginning with the formation and development of the reproductive organs during your puberty, one of the two testicles must be correctly functional. And, your body should be able to produce testosterone and other male hormones to generate and preserve sperm production.

  • Sperm and semen mix

As the sperm  are produced in the testicles,  they get transported through delicate tubes to mix with the semen and are ejaculated out of the male organ upon reaching climax.

  • How many sperm needed in the semen?

In fact, it is all about just one sperm! The nature wants you to bear a healthy baby.  And, thus, has created such a system that the healthiest sperm reaches the woman’s egg to fertilize it and make an embryo.  You need quite a number of sperm to participate in the health competition. If the sperm count is low in your semen, there is a less chance of one of them reaching your partner’s egg, penetrating it to fertilize and make an embryo.  Less than 15 million sperm a mililiter or less than 39 million in one ejaculate are considered  to have low sperm count.

  • Are your sperm functional and able to move?

Your sperm have to be functional and their movement has to be normal.  In case of unhealthy sperm or abnormal movement, also called motility, they will not be able to reach the egg and penetrate it.  Hence the fertilization to create an embryo will not take place.  Medical causes Medical problems are some of the causes for male infertility. Let us discuss some of them:

  • Varicocele (Varicose Veins)

In a medical condition called  varicocele, the veins that help in draining the testicles get elongated, dilated and sometimes tortuous. It is one of the most common causes of male infertility and nearly 15% males suffer from this. Varicoceles are generally non-cancerous and not a life-threatening disease.  Why does varicoceles cause infertility is not known, but it is presumed to be because of unregulated testicular temperature, poor functioning of valves or increased blood flow resistance. Varicoceles have mostly been asymptomatic but sometimes can cause uncomfortable scrotal pain.  The quality of your sperm is affected because of this. With the proper treatment of varicocele, the number of sperm can be increased and their function can also improve.  Experts believe that the outcome also gets  improved when in vitro fertilization (IVF) techniques are used.

  • Infection

Some of the  infections may affect the sperm production or their health. And, some of them cause scarring which obstructs the passage of sperm. These infections may  inflame the epididymis (epididymitis) or the testicles (orchitis) and render the person infertile. Some sexually transmitted infections (STIs) such as chlamydia or gonorrhea or HIV may develop permanent testicular damage yet infertility experts are able to retrieve the sperm and use them in techniques like IVF.

  • Ejaculation issues

In case the semen enters the bladder instead of coming out of the tip of the male organ during orgasm, it is called retrograde ejaculation. And, this condition of retrograde ejaculation is caused by diabetes, bladder surgery, spinal injuries, medications, prostate or urethra. In some cases, men can’t ejaculate semen because of spinal cord injuries or any other disease, although they  have been producing sperm. In such cases, sperm are retrieved for using them in IVF.

  • Antibodies attack sperm

There are anti-sperm antibodies cells produced by your immune that erroneously  recognize sperm as harmful intruders and try to remove them.

  • Tumors

Cancerous or non-malignant tumors may directly impinge on the male reproductive organs. The glands that release hormones relating to reproduction,  like the pituitary gland, or some other branch of the reproductive organs gets affected. In many cases,  radiation or chemotherapy or surgery to remove tumors may cause male infertility.

  • Undescended testicles

Undescended testicles are the medical condition wherein the testicle has not moved or descended to the skin below the penis called the scrotum before birth.  Though this happens very rarely in babies that are born prematurely. Generally, one testicle is affected, but in about 10% of such cases even both the testicles get affected. In majority of the cases, the undescended testicle moves to its proper position automatically within a few months of birth.  But if does not happen, a surgery to put it in place is carried out. Males having this condition will have fewer fertility.

  • Hormonal imbalances

 A very small percentage of male infertility is caused by hormonal imbalances.  The hormonal chain of events is regulated by the hypothalamus-pituitary endocrine system. The system facilitates the testes to not only produce sperms, but also disseminate them in an effective manner.  Many things may go wrong with the functions of the hypothalamus-pituitary endocrine system like:

  • The brain may not succeed in releasing gonadotropins-releasing hormone (Gn-RH) as it should be. Gonadotropin-Releasing Hormone (Gn-RH) fuels the hormonal path that causes testosterone fusion and sperm production.
  • A disorder in Gn-RH release amounts to  testosterone  deficiency leading to stoppage of sperm production.
  • The pituitary gland may not produce enough follicle stimulating hormone (FSH) and luteinizing hormone (LH) to activate the testes and testosterone that help in sperm production.  LH and FSH act as intermediary in the hormonal trail accountable for testosterone and production of sperm.
  • The Leydig cells in the testes may not generate testosterone in reaction to the LH stimulus.

Sometimes, a male may generate other hormones and composite chemicals which obstruct the sex-hormone balance. Infertility is the result of testicle disorders themselves or a malfunctioning influencing other hormonal systems such as hypothalamus, thyroid, pituitary and adrenal glands. There are many fundamental causes for low testosterone (male hypogonadism) and many other hormonal imbalances.

  • Defects of tubules that transport sperm

The tubes that carry sperm may get blocked because of various reasons like accidental injury from surgery, previous infections, distress or atypical development,  like cystic fibrosis or similar hereditary conditions. Blockage can  happen at any stage – in the testicle, in the veins that drain the testicle, in the epididymis, in the vas deferens, next to the ejaculatory pipe or in the urethra.

  • Chromosome defects

One out of 1000 males is born with a genetic disorder like Klinefelter’s syndrome — wherein a male, instead of one X and one Y chromosome, is born with XX (two X) chromosomes and one Y chromosome. The syndrome causes abnormal growth of the male reproductive organs. There are other genetic syndromes like cystic fibrosis, Kartagener’s  syndrome and Kallmann’s syndrome linked to male infertility.

  • Problems with intercourse

A male may have one or more problems while copulating  with his spouse. They include:

  • Problem in keeping or maintaining erection. It is also called erectile dysfunction.
  • Premature ejaculation
  • Painful intercourse
  • Having urethral opening below the penis (hypospadias)
  • Psychological problem
  • Strained relationship with the partner
  • Celiac disease

Celiac disease is a digestive disorder wherein gluten ingestion damages the small intestine.  One out of 100 people, on an average, suffer from this disease. Celiac disease is a genetic and often runs in the family. The disease may render the patient infertile.  Once the person adopts a gluten-free diet, the fertility will begin improving.

  • Certain medications

Prolonged use of anabolic steroids, testosterone replacement therapy, chemotherapy for removing cancerous cells, some anti-fungal medicines,  ulcer curing drugs and some other medications can weaken sperm production and lessen male fertility.

  • Surgeries

There are some surgeries that may obstruct entering sperm in your semen.  They are:

  • Vasectomy
  • Scrotal or testicular surgeries
  • Prostate surgeries
  • Inguinal hernia repairs
  • Large abdominal surgeries done for removing testicular and rectal cancers

Mostly, surgery is done in removing these blockages or for retrieving sperm from the testicles and epididymis directly.

 Environmental causes

Excessive exposure to environmental toxins, heat and chemicals may decrease sperm production or their functions. Particular causes may include, among others:

  • Industrial chemicals

Prolonged exposure to industrial chemicals may lead to low sperm counts. These chemicals may include:

    •  Benzenes
    • Toluene
    • Xylene
    • Pesticides
    • Herbicides
    • Organic solvents and
    • Painting materials
  • Heavy metal exposure

Exposure to heavy metals like lead, etc. may render any male infertile.

Any kind of radiation exposure affects sperm production, though in some cases  it returns to normal once the radiation therapy is stopped. If the radiation doses are high, sperm production may get affected permanently.

  • Overheating the testicles

High temperatures harm sperm production and  their functions. Regular use of saunas or bath in hot tubs may harm your sperm count. The scrotal temperature ought to be 2 degrees lesser than the body temperature. Sitting for a long period,  tight-clothing or working on a computer for long hours also may raise the scrotum temperature and decrease sperm production.

 Health, lifestyle and other causes

Some of the other causes related to health, lifestyle causes of male infertility are:

  • Illicit drug use

Some males take anabolic steroids to fuel muscle strength and development causes shrinkage of testicles to decreased amount of sperm production. Consuming cocaine or marijuana may decrease the number and of your sperm  quality, though temporarily. As soon as you stop consuming them, the sperm count and their quality may get a boost.

  • Alcohol use

Consuming alcohol may  reduce levels of testosterone and cause erectile problem and reduce sperm production. Your liver may get affected by excessive drinking  and render the person infertile.

  • Smoking

Smoking may lead to decreased sperm count. Studies have revealed that smokers will have lesser number of sperm as compared to those men who do not smoke. Even second-hand smoking is harmful to male fertility.

  • Stress

Stress impedes hormones that are needed to generate sperm. If the stress is severe or long-lasting, it does affect your sperm count and, thus, fertility problems.

  • Weight

Obesity  damages fertility in many ways. It directly impacts sperm count adversely and cause hormonal changes that decrease the male fertility. Certain professions like that of welding or requiring drawn out sitting, may be linked with the risk of infertility.

Infertility Treatment FAQs – Part I: What is Infertility

Infertility Treatment FAQs – Part II: 11- risk factors of  both male and female infertility?

Infertility Treatment FAQs – Part III: What are Female Infertility risk factors

Infertility Treatment FAQs – Part IV: What are Male Infertility risk factors

Infertility Treatment FAQs – Part V: What are causes of Female Infertility?

Infertility Treatment FAQs – Part VII: Female Infertility Symptoms

Infertility Treatment FAQs – Part VIII: Infertility Symptoms in Men

Infertility Treatment FAQs – Part IX: Infertility Treatment in India

Infertility Treatment FAQs – Part X: Evaluating Female Infertility

Infertility Treatment FAQs – Part XI: Evaluating Male Infertility

Infertility Treatment FAQs – Part XII: What infertility treatments are available?

Infertility Treatment FAQs – Part XIII: Male Infertility Treatments and drugs

Infertility Treatment FAQs – Part XIV: Female Infertility

Infertility Treatment  FAQs – Part XV: Assisted Reproductive Technology

Infertility Treatment FAQs – Part XVI:  Gamete Intrafallopian Transfer (GIFT)

Infertility Treatment FAQs – Part XVII: Intrauterine Insemination

Infertility Treatment FAQs – Part XVIII: Zygote Intrafallopian Transfer (ZIFT)

Infertility Treatment FAQs – Part XIX: Polycystic Ovary Syndrome (PCOS)

Infertility Treatment FAQs – Part XX: Ovulation Induction (OI)

Infertility Treatment FAQs – Part XXI:  Sperm Morphology

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